Asset Details
Do you wish to reserve the book?
Changes in limitations of life-sustaining treatments over time in a French intensive care unit: A prospective observational study
Hey, we have placed the reservation for you!
By the way, why not check out events that you can attend while you pick your title.
Oops! Something went wrong.
Looks like we were not able to place the reservation. Kindly try again later.
Are you sure you want to remove the book from the shelf?
Changes in limitations of life-sustaining treatments over time in a French intensive care unit: A prospective observational study
Do you wish to request the book?
Changes in limitations of life-sustaining treatments over time in a French intensive care unit: A prospective observational study
Please be aware that the book you have requested cannot be checked out. If you would like to checkout this book, you can reserve another copy
We have requested the book for you!
Your request is successful and it will be processed during the Library working hours. Please check the status of your request in My Requests.
Oops! Something went wrong.
Looks like we were not able to place your request. Kindly try again later.
Journal Article
Changes in limitations of life-sustaining treatments over time in a French intensive care unit: A prospective observational study
2018
Overview
Variability exists between ICUs in the limitations of therapy. Moreover practices may evolve over time. This single-center observational study aimed to compare withholding or withdrawing practices between 2012 and 2016.
For each period and patient concerned by limitations, withholding “do-not start”, withholding “do-not-increase” and withdrawal measures were recorded.
At a four-year interval, the rate of patients undergoing withholding or withdrawal rose from 10 to 23% and 4 to 7%, respectively. The proportion of patients dying in the ICU with previous limitations increased (53 to 89%), as did patients discharged alive despite withholding instructions (12 to 36%). The overall mortality (28%) was stable over time as the rate of failed resuscitation attempt declined (47 to 11%). In 2016 vs 2012, limitations started earlier following admission: 1 vs 7 days for withholding” do-not-start”, 4 vs 8 for withholding “do-not-increase”, 4 vs 7 for withdrawal. Notwithstanding the outcome and limitations applied, the median length of ICU stay of patients involved dropped from 13 days in 2012 to 8 days in 2016.
A timely inclination to forego hopeless treatments resulted in a lower rate of failed resuscitations before death without change in global mortality.
•Treatment limitations are increasingly common and occurred earlier during ICU stay.•Patient's wishes regarding end-of-life care should be better addressed by caregivers.•Advance care planning reduces both ICU stay and the rate of failed resuscitations.
Publisher
Elsevier Inc,Elsevier Limited
